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Nighttime blood pressure (BP) and BP dipping (daytime-nighttime BP) are prognostic for cardiovascular disease. When compared with other racial/ethnic groups, Black Americans exhibit elevated nighttime BP and attenuated BP dipping. Neighborhood deprivation may contribute to disparities in cardiovascular health, but its effects on resting and ambulatory BP patterns in young adults are unclear. Therefore, we examined associations between neighborhood deprivation with resting and nighttime BP and BP dipping in young Black and White adults. We recruited 19 Black and 28 White participants (23 males/24 females, 21 ± 1 yr, body mass index: 26 ± 4 kg/m2) for 24-h ambulatory BP monitoring. We assessed resting BP, nighttime BP, and BP dipping (absolute dip and nighttime:daytime BP ratio). We used the area deprivation index (ADI) to assess average neighborhood deprivation during early and mid-childhood and adolescence. When compared with White participants, Black participants exhibited higher resting systolic and diastolic BP (Ps ≤ 0.029), nighttime systolic BP (114 ± 9 vs. 108 ± 9 mmHg, P = 0.049), diastolic BP (63 ± 8 vs. 57 ± 7 mmHg, P = 0.010), and attenuated absolute systolic BP dipping (12 ± 5 vs. 9 ± 7 mmHg, P = 0.050). Black participants experienced greater average ADI scores compared with White participants [110 (10) vs. 97 (22), P = 0.002], and select ADI scores correlated with resting BP and some ambulatory BP measures. Within each race, select ADI scores correlated with some BP measures for Black participants, but there were no ADI and BP correlations for White participants. In conclusion, our findings suggest that neighborhood deprivation may contribute to higher resting BP and impaired ambulatory BP patterns in young adults warranting further investigation in larger cohorts.NEW & NOTEWORTHY We demonstrate that young Black adults exhibit higher resting blood pressure, nighttime blood pressure, and attenuated systolic blood pressure dipping compared with young White adults. Black adults were exposed to greater neighborhood deprivation, which demonstrated some associations with resting and ambulatory blood pressure. Our findings add to a growing body of literature indicating that neighborhood deprivation may contribute to increased blood pressure.
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Negro ou Afro-Americano , Monitorização Ambulatorial da Pressão Arterial , Pressão Sanguínea , Ritmo Circadiano , População Branca , Humanos , Feminino , Masculino , Adulto Jovem , Características de Residência , Fatores Raciais , Disparidades nos Níveis de Saúde , Adolescente , Hipertensão/fisiopatologia , Hipertensão/etnologia , Hipertensão/diagnósticoRESUMO
OBJECTIVE: An emerging literature suggests that sleep may play an important role in moderating the association between discrimination and mental health problems among adolescents. However, few if any studies have considered this topic among adults. Addressing this knowledge gap, the current study examined multiple sleep parameters as moderating variables in the association between discrimination and mental health problems among adults. METHODS: Participants were 874 adults residing in small towns and semirural contexts within the Southeastern region of the United States ( Mage = 41 years, SD = 7; 57% female; 31% Black, 69% White; 52% income-to-needs < 2). Sleep duration and night-to-night variability in duration were assessed using wrist actigraphy. Established self-report measures were used to assess global sleep problems, experiences of discrimination, and mental health problems (anxiety, depression, and externalizing symptoms). RESULTS: Experiences of discrimination were associated with more depression, anxiety, and externalizing problems. Two out of three sleep parameters were found to moderate the effects of discrimination on mental health. The association between discrimination and externalizing problems (but not anxiety or depression) was attenuated among those with less night-to-night variability in sleep duration. The associations between discrimination and anxiety and externalizing problems (but not depression) were attenuated among those with fewer global sleep problems. Less variability in sleep duration and fewer global sleep problems were also directly associated with lower levels of depression, anxiety, and externalizing problems. CONCLUSIONS: Greater consistency in sleep duration from night-to-night, and fewer overall sleep problems appear to mitigate risk of mental health problems among adults, particularly in contexts where discrimination is prevalent.
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Transtornos do Sono-Vigília , Humanos , Feminino , Masculino , Adulto , Transtornos do Sono-Vigília/epidemiologia , Pessoa de Meia-Idade , Ansiedade/epidemiologia , Depressão/epidemiologia , Actigrafia , Sudeste dos Estados Unidos/epidemiologiaRESUMO
Stress is associated with activation of the hypothalamus-adrenal-axis (HPA). Cortisol, a product of the HPA, is thought to predict depression. However, to date, the majority of studies investigating the cortisol-depression relationship have been cross-sectional and results have been mixed. One possible reason for these mixed findings, may be that many studies fail to consider the moderating role of dehydroepiandosterone (DHEA), which is released alongside cortisol and is thought to serve opposing functions. Therefore, the present study investigated the main and interactive effects of cortisol and DHEA on depressive symptoms. Salivary cortisol and DHEA were measured from saliva throughout the Trier Social Stress task for N = 417 participants at baseline. Participants reported on their depressive symptoms using the Beck Depression Inventory - II at both baseline and follow up (ranging from 1-20 months post baseline; M = 11.60, SD = 5.80) as well as general demographics. The lavaan package in R (version 0.6.11; Rosseel, 2012) was used to conduct multiple regression analyses with FIML to explore the relationships between these variables. Results demonstrated no main effect of cortisol or DHEA, but did show a significant interaction with DHEA. The relations between cortisol and depressive symptoms depended on levels of DHEA such that the relationship was positive at low and negative at high levels of DHEA, with the overall interaction significant (ß = -.22, p < .001, 95% CI = [-.333, -.115]). DHEA can act as a protective factor against depression when cortisol levels are high. This presents opportunities for future research on how to improve DHEA levels to potentially reduce depression.
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Desidroepiandrosterona , Depressão , Humanos , Desidroepiandrosterona/análise , Hidrocortisona/análise , Estudos Transversais , Sistema Hipotálamo-Hipofisário/química , Sistema Hipófise-Suprarrenal/química , Saliva/químicaRESUMO
Background: Ambulatory blood pressure (BP) monitoring measures nighttime BP and BP dipping, which are superior to in-clinic BP for predicting cardiovascular disease (CVD), the leading cause of death in America. Compared with other racial/ethnic groups, Black Americans exhibit elevated nighttime BP and attenuated BP dipping, including in young adulthood. Social determinants of health contribute to disparities in CVD risk, but the contribution of neighborhood deprivation on nighttime BP is unclear. Therefore, we examined associations between neighborhood deprivation with nighttime BP and BP dipping in young Black and White adults. Methods: We recruited 21 Black and 26 White participants (20 M/27 F, mean age: 21 years, body mass index: 25±4 kg/m2) for 24-hour ambulatory BP monitoring. We assessed nighttime BP and BP dipping (nighttime:daytime BP ratio). The area deprivation index (ADI) was used to measure neighborhood deprivation. Associations between ADI and ambulatory BP were examined. Results: Black participants exhibited higher nighttime diastolic BP compared with White participants (63±8 mmHg vs 58±7 mmHg, p=0.003), and attenuated BP dipping ratios for both systolic (0.92±0.06 vs 0.86±0.05, p=0.001) and diastolic BP (0.86±0.09 vs 0.78±0.08, p=0.007). Black participants experienced greater neighborhood deprivation compared with White participants (ADI scores: 110±8 vs 97±21, p<0.001), and ADI was associated with attenuated systolic BP dipping (ρ=0.342, p=0.019). Conclusions: Our findings suggest neighborhood deprivation may contribute to higher nighttime BP and attenuated BP dipping, which are prognostic of CVD, and more prevalent in Black adults. Targeted interventions to mitigate the effects of neighborhood deprivation may help to improve nighttime BP. Clinical Trial Registry: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04576338.
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OBJECTIVE: Belonging is often considered a buffer against the physical and emotional consequences of discrimination and racial climate stress Youth Soc. 48(5):649-72, 2016. However, recent research suggests that feelings of belonging toward an institution can be detrimental when an individual feels discriminated against by the same institution to which one feels a sense of connection J Behav Med. 44(4):571-8, 2021. Therefore, the present study aimed to investigate the moderating role of institutional belonging in the relationship between racial climate stress and health, as indexed by allostatic load (AL), a multi-system indicator of physiological dysregulation. METHODS: In a sample of Black and White college students (N = 150; White = 82; Black = 68), self-reported racial climate stress, institutional belonging, and various demographic variables were collected. An AL composite was also collected, comprised of six biological measures of the SAM system, HPA axis, cardiovascular system, and metabolic system. Multiple regression analyses were conducted to explore the relationships between these variables. RESULTS: Results demonstrated no main effect of racial climate stress on AL but did show a significant interaction between racial climate stress and belonging, such that the positive relationship between racial climate stress and AL was significant only for those who also felt high levels of institutional belonging (ß int = .05, p = .006, 95% CI = 0.01 - 0.08). CONCLUSIONS: Feeling a sense of belonging may have negative physiological consequences for those who experience racial climate stress in a college setting.
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BACKGROUND: Inadequate hydration is associated with cardiovascular and kidney disease morbidity and all-cause mortality. Compared with White individuals, Black individuals exhibit a higher prevalence of inadequate hydration, which may contribute to racial health disparities. However, the underlying reasons for these differences in hydration remain unclear. OBJECTIVE: This cross-sectional study aimed to investigate whether neighborhood deprivation contributes to racial differences in hydration status. METHODS: We assessed 24 Black and 30 White college students, measuring 24-hour urine osmolality, urine flow rate, urine specific gravity, and plasma copeptin concentration. Participants recorded their food and fluid intake for 3 d to assess total water intake from food and beverages. Neighborhood socioeconomic deprivation was measured using a tract-level Area Deprivation Index. RESULTS: Black participants exhibited higher urine osmolality (640 [314] compared with 440 [283] mOsm/kg H2O, respectively, P = 0.006) and lower urine flow rate (1.06 [0.65] compared with 1.71 [0.89] ml/min, respectively, P = 0.009) compared with White participants, indicating greater hypohydration among Black participants. Black participants reported lower total water intake from food and beverages than White participants (2.3 ± 0.7 compared with 3.5 ± 1.1 L/day, respectively, P < 0.01). Black participants exhibited higher copeptin than White participants (6.3 [3.1] compared with 4.5 [2.3] pmol/L, P = 0.046), and urine osmolality mediated 67% of the difference (P = 0.027). Black participants reported greater cumulative exposure to neighborhood deprivation during childhood (ages 0-18 y). Furthermore, neighborhood deprivation during childhood was associated with urine specific gravity (P = 0.031) and total water intake from food and beverages (P = 0.042) but did not mediate the racial differences in these measures. CONCLUSION: Our data suggest that compared with White young adults, Black young adults are hypohydrated and exhibit higher plasma copeptin concentration, and that greater neighborhood deprivation is associated with chronic underhydration irrespective of race. This trial was registered at clinicaltrials.gov as NCT04576338.
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Ingestão de Líquidos , Urinálise , Humanos , Adulto Jovem , Estudos Transversais , Fatores Raciais , Concentração OsmolarRESUMO
OBJECTIVES: Socioeconomic status (SES) and neighborhood context are influential predictors of adolescent sleep, yet little is known about how they may interact to influence sleep. We examined multiple dimensions of family SES as moderators of associations between neighborhood risk and multiple sleep parameters. METHODS: Participants were 323 adolescents (Mage = 17.4 years, SD = 0.86; 48% male; 60% White/European American, 40% Black/African American). Sleep was assessed using 7 nights of actigraphy from which sleep duration (minutes from onset to wake time), efficiency, long wake episodes, and variability in minutes over the week were derived. Youth reported on their sleep/wake problems and sleepiness, as well as their perceptions of safety and violence in their neighborhoods. Parents reported on SES indices, including income-to-needs ratio and perceived financial stability. RESULTS: Lower SES (income-to-needs, perceived financial stability) was associated with lower sleep efficiency and more frequent long wake episodes. Lower neighborhood safety and greater community violence concerns were related to greater subjective sleep problems. Moderation effects illustrated two general patterns. For actigraphy-derived sleep variables, lower neighborhood safety was associated with poor sleep only among youth from lower-income families. For subjective sleep/wake problems and daytime sleepiness, associations between neighborhood risk and sleep difficulties were pronounced for higher SES youth, while lower SES youth had greater sleep problems regardless of neighborhood factors. CONCLUSIONS: Findings suggest that several dimensions of SES and neighborhood risk may be consequential for adolescents' sleep. Moderation effects highlight the significance of considering multiple contextual influences towards a better understanding of adolescents' sleep.
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Distúrbios do Início e da Manutenção do Sono , Transtornos do Sono-Vigília , Humanos , Masculino , Adolescente , Feminino , Classe Social , Sono , Transtornos do Sono-Vigília/epidemiologia , Características da VizinhançaRESUMO
OBJECTIVE: To examine social class discrimination as a mediator of socioeconomic disparities in sleep outcomes in an adolescent sample. METHODS: Sleep was assessed from established actigraphy (efficiency, long wake episodes, duration) and self-report (sleep/wake problems, daytime sleepiness) measures among 272 high school students in the Southeastern region of the United States (35% low income; 59% White, 41% Black, 49% female, Mean age = 17.3, SD = 0.8). Social class discrimination was assessed using a new measure, the Social Class Discrimination Scale (SCDS; 22-items), and an established measure, the Experiences of Discrimination Scale (EODS; 7-items). Socioeconomic disadvantage (SED) was measured as an aggregate of six indicators. RESULTS: The SCDS was associated with sleep efficiency, long wake episodes, sleep/wake problems and daytime sleepiness (but not sleep duration), and significantly mediated the socioeconomic gradient in each sleep outcome. Black males experienced higher levels of social class discrimination than Black females, White males, or White females. A race by gender moderation effect was evident for two of the five sleep outcomes (sleep efficiency and long wake episodes) suggesting a stronger association between social class discrimination and sleep problems for Black females than White females but no clear race differences among males. The EODS was not associated with objective sleep outcomes or SED but was associated with self-reported sleep and showed a similar pattern of moderation effects. CONCLUSIONS: Findings suggest that social class discrimination may contribute to socioeconomic disparities in sleep problems, with some variability across measures and demographic groups. Results are discussed in light of evolving trends in socioeconomic health disparities.
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Distúrbios do Sono por Sonolência Excessiva , Transtornos do Sono-Vigília , Masculino , Humanos , Adolescente , Feminino , Estados Unidos , Autorrelato , Disparidades Socioeconômicas em Saúde , Actigrafia , Classe SocialRESUMO
OBJECTIVE: The objective of this study was to examine whether experiences of discrimination have increased during the pandemic, particularly among negatively stigmatized racial/ethnic groups, and whether such experiences have exacerbated feelings of social isolation. METHOD: Discrimination and social isolation were assessed before and during the pandemic in a sample of 263 Black and White young adults attending a large, predominantly White 4-year research university in the Southeastern region of the United States (52% Black, 48% White, 53% female, mean age = 19.2). RESULTS: Increases in discrimination were evident among Black but not White participants. Black participants also reported greater increases in social isolation than White participants, and changes in discrimination partially mediated the emergent racial disparity in social isolation. CONCLUSIONS: Findings are consistent with theoretical perspectives on discrimination during times of stress and suggest the need for broader attention to the impact of the pandemic on unfair treatment of stigmatized groups. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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The influence of childhood contexts on adult blood pressure is an important yet understudied topic. Using a developmental perspective, this study examines the association between neighborhood socioeconomic disadvantage in early childhood (0-5 yrs), middle childhood (6-12 yrs) and adolescence (13-18 yrs) on subsequent blood pressure in young adulthood. Data were from 263 college students (52% Black; Mage = 19.21 years) and neighborhood socioeconomic disadvantage was measured using a tract-level Area Deprivation Index. Neighborhood disadvantage in early childhood was significantly associated with diastolic blood pressure and explained 22% of the race difference between Black and White adults. The findings are consistent with the notion that early childhood may be a sensitive period for the effects of neighborhood disadvantage on blood pressure.
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Grupos Raciais , Características de Residência , Adolescente , Adulto , Pressão Sanguínea , Criança , Pré-Escolar , Humanos , Fatores Socioeconômicos , Estudantes , Adulto JovemRESUMO
We examined whether prevalence of social class discrimination-and its association with psychological distress-has changed between 1990s and 2010s in the United States. Data were from the original Midlife in the United States (MIDUS) study with data collections in 1995-1996 (n = 2931) and 2004-2005 (n = 1708), and the new MIDUS Refresher sample from 2011 to 2014 (n = 2543). Socioeconomic status (SES) became more strongly associated with self-rated discrimination over time, with individuals with the lowest SES experiencing more discrimination (B = 0.75, p < .001) and those with the highest SES less discrimination (B = 0.36, p < .001) over time: at baseline, the difference in self-rated discrimination between the highest and lowest SES groups was 15.3% versus 10.8% (4.7% point difference). This difference increased to 20.0% versus 7.4% in the last study wave (12.6% point difference). Association between self-reported discrimination and psychological distress strengthened over time, but the associations between socioeconomic indicators and distress did not change. The results suggest that people with low SES had higher risk of encountering unfair and disrespectful treatment in the 2010s compared to the 1990s.
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Renda , Classe Social , Estados Unidos , Humanos , Autorrelato , Fatores Socioeconômicos , Coleta de DadosRESUMO
Policy Points Policies that increase county income levels, particularly for middle-income households, may reduce low birth weight rates and shrink disparities between Black and White infants. Given the role of aggregate maternal characteristics in predicting low birth weight rates, policies that increase human capital investments (e.g., funding for higher education, job training) could lead to higher income levels while improving population birth outcomes. The association between county income levels and racial disparities in low birth weight is independent of disparities in maternal risks, and thus a broad set of policies aimed at increasing income levels (e.g., income supplements, labor protections) may be warranted. CONTEXT: Low birth weight (LBW; <2,500 grams) and infant mortality rates vary among place and racial group in the United States, with economic resources being a likely fundamental contributor to these disparities. The goals of this study were to examine time-varying county median income as a predictor of LBW rates and Black-White LBW disparities and to test county prevalence and racial disparities in maternal sociodemographic and health risk factors as mediators. METHODS: Using national birth records for 1992-2014 from the National Center for Health Statistics, a total of approximately 27.4 million singleton births to non-Hispanic Black and White mothers were included. Data were aggregated in three-year county-period observations for 868 US counties meeting eligibility requirements (n = 3,723 observations). Sociodemographic factors included rates of low maternal education, nonmarital childbearing, teenage pregnancy, and advanced-age pregnancy; and health factors included rates of smoking during pregnancy and inadequate prenatal care. Among other covariates, linear models included county and period fixed effects and unemployment, poverty, and income inequality. FINDINGS: An increase of $10,000 in county median income was associated with 0.34 fewer LBW cases per 100 live births and smaller Black-White LBW disparities of 0.58 per 100 births. Time-varying county rates of maternal sociodemographic and health risks mediated the association between median income and LBW, accounting for 65% and 25% of this estimate, respectively, but racial disparities in risk factors did not mediate the income association with Black-White LBW disparities. Similarly, county median income was associated with very low birth weight rates and related Black-White disparities. CONCLUSIONS: Efforts to increase income levels-for example, through investing in human capital, enacting labor union protections, or attracting well-paying employment-have broad potential to influence population reproductive health. Higher income levels may reduce LBW rates and lead to more equitable outcomes between Black and White mothers.
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População Negra , Mães , Adolescente , Peso ao Nascer , Feminino , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido de Baixo Peso , Recém-Nascido , Gravidez , Estados Unidos/epidemiologiaRESUMO
STUDY OBJECTIVES: We examined multiple actigraphy-based sleep parameters as moderators of associations between experiences of general and racial discrimination and adolescent internalizing symptoms (anxiety, depression) and externalizing behavior (rule-breaking). Adolescent sex and race were examined as additional moderators. METHODS: Participants were 272 adolescents (Mage = 17.3 years, SD = 0.76; 51% male; 59% White/European American, 41% Black/African American). Sleep was assessed using actigraphs for 7 consecutive nights from which sleep duration (minutes), efficiency, and variability in minutes over the week were derived. Youth reported on their experiences of general discrimination, racial discrimination, anxiety, depressive symptoms, and rule-breaking behavior. RESULTS: Both types of discrimination were associated with poorer adjustment outcomes. Longer sleep duration, greater sleep efficiency, and less variability in sleep duration were protective in associations between race-specific and general discrimination and internalizing symptoms. Findings for duration and efficiency were more pronounced for females such that the adverse effects of discrimination were minimized among females with longer and more efficient sleep. Greater variability in sleep exacerbated rule-breaking behavior among adolescents experiencing general or racial discrimination. Associations did not differ by adolescent race. CONCLUSIONS: Short and poor-quality sleep may exacerbate internalizing symptoms for adolescents experiencing discrimination, particularly females. Variability in sleep duration was a key moderator of associations between discrimination and internalizing symptoms as well as rule-breaking behavior. Findings illustrate that actigraphy-assessed sleep parameters play a key role in ameliorating or exacerbating adjustment problems associated with discrimination.
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Racismo , Distúrbios do Início e da Manutenção do Sono , Actigrafia , Adolescente , Feminino , Humanos , Masculino , Sono , População BrancaRESUMO
With unprecedented increases, mortality trends in the United States have received significant attention in recent years. To date, research on this topic has emphasized specific causes of death and proximal behavioral or physiological determinants. In this commentary, I consider novel contributions of Zheng and Echave (Am J Epidemiol. 2021;190(11):2242-2255) in examining trends in mental health, health behaviors, and physiological dysregulation. I then discuss broader developments in related research and make a case for: 1) not allowing recent health trends among Whites to overshadow the urgent work that needs to be done to mitigate persistent racial inequities, 2) further investigation of what accounts for increases in income inequality and its life-span health consequences, and 3) broadening the scope of mechanisms considered to include underdiscussed topics such as the role of increases in social media use or environmental toxicant exposures. Underlying several potential explanations for observed trends in health and mortality is the fact that substantial change has occurred on multiple fronts in US society and that policy responses to these changes have been insufficient. An enhanced emphasis on innovative population health research will be essential to provide the evidence base needed for policy makers to rise to these urgent challenges.
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Saúde da População , Humanos , Renda , Política Pública , Grupos Raciais , Estados Unidos/epidemiologia , População BrancaRESUMO
African American women with systemic lupus erythematosus (SLE) have worse disease outcomes compared to their White counterparts. Stressors associated with race may contribute to poorer health in this population through maladaptive behavioral pathways. This study investigated relationships between stress associated with anticipating racism, smoking, and SLE disease activity. Data were from 432 African American women with SLE in the Black Women's Experiences Living with Lupus (BeWELL) Study. Controlling for sociodemographic and health-related covariates, multivariable regression analyses revealed a significant association between anticipatory racism stress (ARS) and disease activity (p = 0.00, b = 1.13, 95% CI [0.43, 1.82]). A significant interaction between ARS and smoking also indicated that smoking exacerbated the effect of ARS on disease activity (p = 0.04, b = 1.95, CI = 0.04, 3.96). Test for evidence of smoking mediating the effect of ARS on disease activity were not statistically significant (z = 1.77, p = 0.08). Findings have implications for future SLE disparities research among African American women with SLE.
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Lúpus Eritematoso Sistêmico , Racismo , Negro ou Afro-Americano , Feminino , Humanos , FumarRESUMO
OBJECTIVES: Black adults in the United States have shorter sleep durations and poorer sleep efficiency relative to White adults, yet reasons for these disparities are not well explicated. The objective of this study was to examine neighborhood safety in childhood as a mediator of subsequent racial disparities in sleep. METHODS: Data were from Black and White young adults attending a large, predominantly White university in the Southeastern United States (N = 263; 52% Black, 53% female; Mean age = 19.21 years, SD = 1.01). Sleep parameters were assessed from eight nights of wrist actigraphy (time in bed, sleep duration, and efficiency) and an established self-report measure of daytime sleepiness. Residential histories from birth through age 18 were documented, and retrospective self-reports of neighborhood safety in childhood were assessed. RESULTS: Black participants had less time in bed (p < 0.001), shorter sleep duration (p < 0.001), poorer sleep efficiency (p < 0.001), and more daytime sleepiness (p = 0.009) than White participants. Neighborhood safety mediated race differences in time in bed (p = 0.028), sleep duration (p = 0.033), and daytime sleepiness (p = 0.048), but not sleep efficiency. Findings were substantively unchanged after adjustment for family socioeconomic status, BMI, and substance use. CONCLUSIONS: Findings support the hypothesis that neighborhood safety in childhood may partially account for race differences in subsequent sleep duration and daytime sleepiness. Addressing racial inequities in childhood neighborhood safety may be an important step toward reducing racial disparities in sleep health.
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Negro ou Afro-Americano , Disparidades nos Níveis de Saúde , Adolescente , Adulto , Feminino , Humanos , Masculino , Características de Residência , Estudos Retrospectivos , Sono , Estados Unidos , População Branca , Adulto JovemRESUMO
Understanding the changing health consequences of childhood socioeconomic disadvantage (SED) is highly relevant to policy debates on inequality and national and state goals to improve population health. However, changes in the strength of association between childhood SED and adult health over historic time are largely unexamined in the United States. The present study begins to address this knowledge gap. Data were from 2 national samples of adults collected in 1995 (n = 7,108) and 2012 (n = 3,577) as part of the Midlife in the United States study. Three measures of childhood SED (parents' occupational prestige, childhood poverty exposure, and parents' education) were combined into an aggregate index and examined separately. The association between childhood SED (aggregate index) and 5 health outcomes (body mass index, waist circumference, chronic conditions, functional limitations, and self-rated health) was stronger in the 2012 sample than the 1995 sample, with the magnitude of associations being approximately twice as large in the more recent sample. Results persisted after adjusting for age, sex, race, marital status, and number of children, and were similar across all 3 measures of childhood SED. The findings suggest that the socioeconomic circumstances of childhood might have become a stronger predictor of adult health in recent decades.
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Nível de Saúde , Fatores Socioeconômicos , Populações Vulneráveis , Adulto , Criança , Fatores Epidemiológicos , HumanosRESUMO
The impact of the COVID-19 pandemic on emerging adults is of global concern. We examine changes in depressive symptoms, physical symptoms, and sleep-wake problems from before to during the pandemic among college students, and examine inequalities by gender, socioeconomic status (SES), and race (N=263, 52% Black, 48% White, 53% female). As compared to pre-pandemic levels, increases were evident in depressive symptoms, physical symptoms, and sleep problems. Females had greater increases than males in depressive symptoms, sleep problems, and physical symptoms. Students from disadvantaged SES backgrounds had greater increases in physical symptoms. Among White students, those from disadvantaged backgrounds also had greater increases in sleep problems. Lastly, daytime sleepiness increased more among Black male than White male students. Overall, findings suggest notable shifts in sleep and health during the early phase of the pandemic among emerging adults, and that attention to inequality by gender, SES, and race is warranted.
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Objective/Background: Lower socioeconomic status (SES) is generally associated with poor sleep but little is known about how different SES indices are associated with sleep duration and quality, or about these relations longitudinally or in cohabiting couples. The main objective was to examine longitudinal associations between multiple SES and sleep parameters in cohabiting adults. Participants: Participants were cohabiting couples (N = 135) of women (M age = 37.2 years, SD = 5.93; 76% White/European American, 18% Black/African American) and men (M = 39.9 years, SD = 7.33; 78% White, 18% Black). Methods: Men and women participated twice with a 1-year lag. At Time (T1), participants reported on multiple SES indices including their income, perceived economic well-being, education, employment status, and occupation. Sleep at T1 and T2 was assessed with self-reports and actigraphs (sleep duration from onset to wake time, %sleep from onset to wake, long wake episodes). Results: Actor effects on actigraphy-assessed sleep parameters were evident for both men and women; low SES was associated with shorter duration and poor quality (%sleep, long wake episodes) sleep. These associations were most pronounced for income-to-needs ratio (men and women) and perceived economic well-being (women only). Partner effects were also evident such that men's employment status was associated with women's longer sleep duration and greater sleep quality (%sleep) whereas women's employment predicted increased subjective sleep problems for men. Conclusion: Findings illustrate the need to consider multiple SES and sleep indices, as well as the family context in studies addressing linkages between SES and sleep.